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This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 6 No. 3, March 2005 Author Disclosure E-Letters: Submit a response Alert me when this article is cited Alert me when E-Letters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Madan, A. Articles by Good, W. V. Search for Related Content PubMed Articles by Madan, A. Articles by Good, W. V.

NeoReviews Vol.6 No.3 2005 e153
© 2005 American Academy of Pediatrics

Preterm Birth and the Visual System

Ashima Madan, MD^*
William V. Good, MD

^* Associate Professor of Pediatrics, Stanford University School of Medicine, Stanford, Calif
Smith Kettlewell Eye Research Institute, San Francisco, Calif

Abbreviations: CVI: cortical visual impairment • GCL: ganglion cell layer • IVH: intraventricular hemorrhage • LGN: lateral geniculate nuclei • PCA: postconceptional age • PVL: periventricular leukomalacia • ROP: retinopathy of prematurity • VEP: visual evoked potential

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. Chart the development of the structures of the eye.
   
2. Describe the primary visual problems seen in preterm neonates.
   

	Introduction

 
Despite several interventions, preterm birth remains one of the major causes of poor perinatal outcome. It is estimated that approximately 57,000 preterm infants weighing less than 1,500 g, comprising 1.5% of all live births in the United States, are born each year. (1) Considerable advances in neonatal intensive care in the 1990s, including use of surfactant replacement therapy for preterm infants and antenatal steroid use for women in preterm labor, has led to the increased survival of these infants. However, despite improvements in survival, preterm infants, particularly extremely low-birthweight infants whose birthweights are less than 1,000 g, continue to be at increased risk for abnormal cognitive function, visual-perceptual, visuomotor, and tactile-perceptual skills; cerebral palsy; blindness; and deafness. (2) Many severely handicapped infants have multiple impairments.

Cortical visual impairment has emerged as the major cause of visual impairment in the United States. It is well known that appropriate procession of sensory cues is an important requirement for normal motor, mental, and emotional development in infants, and the association between vision problems and neurologic and mental disability is well recognized in several studies. (3) An increased understanding of the impact of extrauterine stimuli on visual development along with improved methods of detecting vision problems can help in prevention, early diagnosis, and rehabilitation of visual impairment in infants. (4)

In this article, we review current knowledge of visual development in the preterm infant and the spectrum of visual disturbances seen in preterm infants.

	Visual Pathway

 
Visualization of an image requires refraction of light emanating from the object passing through the lens onto the retinal photoceptor layer. The visual stimuli from . . . [Full Text of this Article]